NPIMap

Organization Active NPI

Completely Centered Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Upper Marlboro, MD
National Provider Identifier
1306469457
Registry record updated May 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
COMPLETELY CENTERED HEALTH LLC
Practice address
1116 Mandarin Dr
Upper Marlboro, MD 20774-7024
Phone
(202) 578-9001
NPI assigned
May 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kayee Veronica Wilson, PMHNP-FNP-BCNPI 1679879688
Title
Owner/Cep
Phone
(202) 578-9001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1116 Mandarin Dr
Upper Marlboro, MD 20774-7024

Mailing address

1116 Mandarin Dr
Upper Marlboro, MD 20774-7024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251011000659 DC Part B Supplier - Clinic/Group Practice 0749777043 Receives reassigned benefits from 1 practitioner
Practice locations: Upper Marlboro, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1590192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590192000000",
    "number": "1306469457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 MANDARIN DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207747024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 MANDARIN DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207747024",
            "telephone_number": "202-578-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETELY CENTERED HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-23",
        "last_updated": "2020-05-23",
        "certification_date": "2020-05-23",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KAYEE",
        "authorized_official_middle_name": "VERONICA",
        "authorized_official_title_or_position": "OWNER/CEP",
        "authorized_official_telephone_number": "202-578-9001",
        "authorized_official_credential": "PMHNP-FNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.